scholarly journals Study on the Treatment of Postoperative Pain in Patients Operated for Incisional Hernia by Open or Laparoscopic Approach

2019 ◽  
Vol 56 (1) ◽  
pp. 186-189
Author(s):  
Bogdan Andrei Suciu ◽  
Cristian Trambitas ◽  
Vlad Vunvulea ◽  
Dumitru Godja ◽  
Reka Kaller ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Incisional Hernia ◽  
Surgical Approach ◽  
Laparoscopic Approach ◽  
Common Symptom ◽  
Open Approach ◽  
Laparoscopic Surgical Procedure ◽  
Surgical Meshes ◽  
Analgesic Medication ◽  
Group B

Postoperative pain is a common symptom in the postoperative period in patients treated for incisional hernia, often refractory to treatment. The purpose of the this paper was to conduct a comparative study on the need for analgesic medication in patients operated for incisional hernia through a classical open approach and a laparoscopic approach. In this respect, we performed a retrospective observational study over a period of 4 years in which we introduced 92 patients operated for incisional hernia in the Surgery Clinic No. 1 of the Emergency County Hospital Tirgu Mures. For the reconstruction of the abdominal wall we used prosthetic materials (surgical meshes). All patients included in the study received only metamizole sodium as analgesic medication. The patients studied were divided into two groups: group A (consisting of 57 patients where open, classic surgical approach was used) and group B (consisting of 35 patients treated using a minimally invasive laparoscopic approach). It was observed that on the day of surgery and during the first two postoperative days there are no statistically significant differences in the need for analgesic medication between the studied groups. Instead, starting with the third postoperative day, the need for analgesic medication is much lower in patients where laparoscopic surgical procedure was used than in those where open, classic surgical approach was used.

scholarly journals A comparative study of open preperitoneal versus laparoscopic mesh hernioplasty in cases of incisional hernia repair

2020 ◽  
Vol 7 (10) ◽  
pp. 3360
Author(s):  
Ashish Kharadi ◽  
Vikas Makwana ◽  
Pranav Patel
Keyword(s):  
Incisional Hernia ◽  
Laparoscopic Repair ◽  
Laparoscopic Approach ◽  
Incisional Hernia Repair ◽  
Cross Sectional Study ◽  
Open Approach ◽  
Cross Sectional ◽  
Routine Work ◽  
Bowel Movements ◽  
Pain Duration

Background: Incisional hernias repair being done in large numbers there is still not a consensus about the best repair. Very few studies have been done on comparison open and laparoscopic incisional hernia repair.Methods: A prospective, cross-sectional study was undertaken in Department of Surgery of Civil Hospital. The study included total 50 patients, out of which 25 patients underwent open approach and rest of 25 patients, underwent laparoscopic approach. Patients were assigned to both the groups randomly.Results: Pain, duration of post-operative stay, and return to routine work is earlier in patients with laparoscopic repair mainly due to decreased pain, fewer complications, early mobility and faster return of bowel movements. Laparoscopic repair is more expensive and operative time is more as compared to open method.Conclusions: Keeping in view the advantages and limitations of laparoscopic repair, the choice among two surgical modalities should be made on a case to case basis depending on patient preference and characteristics. 

Appendectomy during Early Pregnancy: What is the Preferred Surgical Approach?

2005 ◽  
Vol 71 (10) ◽  
pp. 809-812 ◽  
Author(s):  
Thomas W. Carver ◽  
Jared Antevil ◽  
John C. Egan ◽  
Carlos V.R. Brown
Keyword(s):  
Birth Weight ◽  
Early Pregnancy ◽  
Surgical Approach ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Open Approach ◽  
Fetal Demise ◽  
Infant Birth ◽  
Length Of Hospitalization

Appendectomy is the most common nongynecologic surgery performed during pregnancy. Although many surgeons offer laparoscopic appendectomy (LA) as an alternative to open appendectomy (OA) during early pregnancy, few studies have compared the effects of LA versus OA on the fetus and the outcome of the pregnancy. Twenty-eight consecutive females undergoing appendectomy for presumed appendicitis in the first two trimesters of pregnancy between January 2000 and December 2002 were identified retrospectively. Demographic information, weeks of pregnancy at operation, and surgical approach (LA or OA) were recorded. Study outcomes included operative and pregnancy-related complications, length of hospitalization, final outcome of pregnancy, and infant birth weight. Seventeen LA and 11 OA were performed. There were no significant differences in surgical or obstetrical complications, length of hospitalization, or birth weight between the two groups. Two cases of postoperative fetal demise were noted in the LA group. Although not statistically significant, the two fetal losses in the laparoscopic group are concerning. The current study did not demonstrate any advantages to the laparoscopic approach. Pending further investigation, the open approach may be preferred for appendectomy in pregnant patients during the first two trimesters of pregnancy.

scholarly journals Prospective trial comparing open approach of Lichtenstein tension-free mesh with laparoscopic transabdominal preperitoneal approach for repair of inguinal hernia: tertiary center experience

2019 ◽  
Vol 6 (11) ◽  
pp. 3927
Author(s):  
Ahmed M. Helmy ◽  
Ahmed A. Aldardeer ◽  
Alaa A. Redwaan
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Open Approach ◽  
Tension Free ◽  
Postoperative Stay ◽  
Group A ◽  
Group B ◽  
Open Mesh

Background: The introduction of various open mesh and laparoscopic techniques has increased the interest in inguinal hernia surgery. But still controversy persists about the most effective inguinal hernia repair. The aim of this study was to compare the results of open Lichtenstein tension-free mesh technique and laparoscopic transabdominal preperitoneal (TAPP) repair for inguinal hernia.Methods: We considered 55 patients were enrolled between. Patients were divided into two groups, group A had open mesh repair and group B had laparoscopic TAPP repair of groin hernia. Time to full recovery and return to work, operative time, postoperative pain, hospital postoperative stay, complications and recurrence rate were recorded in both groups.Results: Significant difference was observed in the median time to return to normal activities in TAPP group versus in open approach. The mean hospital postoperative stay was 1-2 days in both groups. On follow up of our patients we found that in group A 3 patients had seroma, no haematoma discovered among our patients, 3 patients had wound infection, all previous complications were managed conservatively, in group B none of all 30 patients develop seroma, haematoma or infection. In group A 4 patients who were had bilateral hernia develop recurrence, while in group B we had no recurrence among the patients.Conclusions: Laparoscopic (TAPP) approach to inguinal hernia repair is considered safe and effective as excellent alternative to conventional surgery repair. It is associated with less postoperative pain, hospital postoperative stay, postoperative complications, and recurrence, earlier return to normal activities.

scholarly journals Comparative Study on the Need for Postoperative Analgesic Medication After Surgical Treatment of Inguinal Hernia with Surgical Mesh through Laparoscopic or Classic Approach

2018 ◽  
Vol 55 (3) ◽  
pp. 380-384
Author(s):  
Bogdan Andrei Suciu ◽  
Ioana Halmaciu ◽  
Decebal Fodor ◽  
Cristian Trambitas ◽  
Dumitru Godja ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Laparoscopic Technique ◽  
Adequate Treatment ◽  
Surgical Meshes ◽  
Significant Difference ◽  
Analgesic Medication ◽  
Classic Approach

The incidence of postoperative pain in patients operated for inguinal hernia can reach up to 40% of cases, depending on different authors, and depending on the approach used in the surgical treatment of these patients. Currently, there are two commonly accepted ways of surgical treatment of inguinal hernias, the classic approach with polypropylene mesh (Liechtenstein technique) and the laparoscopic approach. The purpose of this study was to conduct a comparative analysis on the need for analgesic medication in patients treated for inguinal hernia either by classic (group A) or by laparoscopic (group B) approach. Surgical meshes were used in all patients enrolled in our trial. The average age of the patients included in this study was 53.79 years, ranging from 20 to 88 years. Regarding the distribution of cases by gender, we observed in the studied lots that 12 cases were women (11.53%) and 92 cases were males (88.46%). In female patients, the classic inguinal hernia approach was performed in 3 cases (25% of cases), and in 9 cases the laparoscopic approach was performed in the surgical treatment of the inguinal hernia (75% of the cases). In male patients, laparoscopic approach was performed in 33 cases (35.86% of cases), and in 59 cases the surgical approach was performed in a classical manner using the Liechtenstein technique (64.13% of the cases). From the statistical analysis of the data we noticed a statistically significant difference in the need for analgesic medication administered to these patients (p = 0.0001). Although surgical correction of inguinal hernia, both classic and laparoscopic approaches, provide adequate treatment for these patients, in case of the laparoscopic technique, immediately after the operation, the need for analgesic medication is lower compared to the classical technique.

scholarly journals Laparoscopic Intervention to Pancreatic Pseudocyst Confers Short-Term Benefits: A Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yulin Guo ◽  
Shun Hu ◽  
Shuo Wang ◽  
Ang Li ◽  
Feng Cao ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Pancreatic Pseudocyst ◽  
Surgical Intervention ◽  
Operating Time ◽  
Surgical Techniques ◽  
Laparoscopic Approach ◽  
Cochrane Library ◽  
Open Approach ◽  
Qualitative Synthesis ◽  
Significant Difference

Background. Surgical interventions for pancreatic pseudocyst (PP) are traditionally managed by an open surgical approach. With the development of minimally invasive surgical techniques, a laparoscopic surgical approach for PPs has been conducted increasingly with comparable outcomes. The present study was conducted to compare the efficacy and safety of surgical intervention for PPs between the laparoscopic approach and the open approach. Methods. Databases including Cochrane Library, PubMed, and EMBASE were searched to identify studies that compared the safety and efficacy of surgical intervention for PPs between the laparoscopic approach and the open approach (until Aug 1st 2020). Results. A total of 6 studies were eligible in qualitative synthesis. The laparoscopic approach was associated with less intraoperative blood loss (MD = −69.97; 95% CI: −95.14 to −44.70, P < 0.00001 ; P = 0.86 for heterogeneity) and shorter operating time (MD = −33.12; 95% CI: −62.24 to −4.00, P = 0.03 ; P < 0.00001 for heterogeneity). There was no significant difference found between the two approaches regarding the success rate and the recurrence rate. The postoperative complications and mortality rates were comparable between the two approaches. Conclusions. The laparoscopic approach for the surgical intervention of PPs is safe and efficacious with shorter-term benefits.

scholarly journals Study on the Need for Postoperative Analgesic Medication in Patients where Polypropylene Mesh was Used in the Surgical Treatment of Incisional Hernias

2018 ◽  
Vol 55 (4) ◽  
pp. 648-651
Author(s):  
Ioana Halmaciu ◽  
Bogdan Andrei Suciu ◽  
Cristian Trambitas ◽  
Vlad Vunvulea ◽  
Alexandra Martin Stoica ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Polypropylene Mesh ◽  
Incisional Hernias ◽  
Surgical Meshes ◽  
Analgesic Medication ◽  
Group A ◽  
Group B ◽  
Surgical Clinic

One of the most common postoperative complications that may occur in patients treated for incisional hernias is pain. The occurrence of postoperative pain refractory to drug treatment may worsen the prognosis of these patients. We have carried out a retrospective observational study in which we have introduced 122 patients operated for incisional hernia at the Surgical Clinic No. 1 in the Tirgu Mures Emergency County Clinical Hospital. The patients included in the study were divided into two groups: group A consisting of 80 patients where the polypropylene mesh was used over the aponeurosis in the surgical treatment of the incisional hernias, and the group B consisting of 42 patients where no prosthetic materials were used in the surgical treatment of the incisional hernias. All patients were administrated 1 g of sodium metamizole monohydrate for the treatment of pain. The statistical analysis of the data revealed that, on the day of surgery, on the first, second and third postoperative day there were statistically significant differences in the need for analgesic medication between the two groups, the need for the analgesic medication being lower for group A. In contrast, on the 4th postoperative day there were no statistically significant differences in the need for analgesic medication between the two groups. In conclusion, our study showed that, when using the polypropylene mesh in the surgical treatment of incisional hernias, the need for analgesic medication is lower in the immediate postoperative period compared to cases where surgical meshes are not used in the surgical treatment of these patients.

scholarly journals Purely laparoscopic feeding jejunostomy: a procedure which deserves more attention

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hsin-I. Tsai ◽  
Ta-Chun Chou ◽  
Ming-Chin Yu ◽  
Chun-Nan Yeh ◽  
Meng-Ting Peng ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Intraoperative Complications ◽  
Postoperative Outcome ◽  
Early Enteral Nutrition ◽  
Chang Gung Memorial Hospital ◽  
Open Approach ◽  
Feeding Jejunostomy ◽  
Laparoscopic Jejunostomy ◽  
Conventional Open Approach ◽  
Laparoscopic Feeding Jejunostomy

Abstract Background Laparoscopic procedure has inherent merits of smaller incisions, better cosmesis, less postoperative pain, and earlier recovery. In the current study, we presented our method of purely laparoscopic feeding jejunostomy and compared its results with that of conventional open approach. Methods We retrospectively reviewed our patients from 2012 to 2019 who had received either laparoscopic jejunostomy (LJ, n = 29) or open ones (OJ, n = 94) in Chang Gung Memorial Hospital, Linkou. Peri-operative data and postoperative outcomes were analyzed. Results In the current study, we employed 3-0 Vicryl, instead of V-loc barbed sutures, for laparoscopic jejunostomy. The mean operative duration of LJ group was about 30 min longer than the OJ group (159 ± 57.2 mins vs 128 ± 34.6 mins; P = 0.001). There were no intraoperative complications reported in both groups. The patients in the LJ group suffered significantly less postoperative pain than in the OJ group (mean NRS 2.03 ± 0.9 vs. 2.79 ± 1.2; P = 0.002). The majority of patients in both groups received early enteral nutrition (< 48 h) after the operation (86.2% vs. 74.5%; P = 0.143). Conclusions Our study demonstrated that purely laparoscopic feeding jejunostomy is a safe and feasible procedure with less postoperative pain and excellent postoperative outcome. It also provides surgeons opportunities to enhance intracorporeal suture techniques.

scholarly journals Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 21-24
Author(s):  
Md Abdus Salam ◽  
Md Mahbub Alam ◽  
Rezwan Ahmed ◽  
Md Sultan Mahmud
Keyword(s):  
Postoperative Pain ◽  
Postoperative Bleeding ◽  
Throat Pain ◽  
Medical College ◽  
Advantages And Disadvantages ◽  
Case Surgery ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Dissection Method

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24

The Modified Open Rhinoplasty

1993 ◽  
Vol 1 (3) ◽  
pp. 131-136
Author(s):  
Laurence T Glickman ◽  
Gene W Lee
Keyword(s):  
Surgical Approach ◽  
Open Rhinoplasty ◽  
Open Approach ◽  
The Past ◽  
External Incision ◽  
Wide Exposure

LT Glickman, GW Lee. The modified open rhinoplasty. Can J Plast Surg 1993;1(3):131-136. Despite considerable attention in the past 10 to 20 years, the open rhinoplasty remains a controversial procedure. Advocates of this technique argue that the exposure and thus the surgical manoeuvres it makes are unequalled. Detractors argue that the transcolumellar scar left by the procedure is unacceptable and is most often unnecessary. This report describes a modification of the open rhinoplasty which has most of the advantages of the open approach, but is performed without the external incision. The procedure, its advantages and drawbacks, and comparisons among the modified open, open and closed rhinoplasty are described. It is concluded that the modified open rhinoplasty is an excellent surgical approach that can be used on most patients and that it provides wide exposure without an external incision.

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